<html>
    <head>
        <title>WineXpress.com: Member Registration</title>
        <meta name="layout" content="main" />
        
    </head>
    <body>
        <div id="pageBody">
            <h1>Member Registration</h1>
            
            <br/>${flash.message}<br/>
            
            <g:form name="registerMemberForm" controller="customerManagement" action="postCreateMember" method="POST">

              <span style="color:red">*</span>required<br/><br/>
              User Name: <input type="text" name="username"/><span style="color:red">*</span><br/>
              E-mail: <input type="text" name="email"/><span style="color:red">*</span><br/>
              Last Name: <input type="text" name="lastName"/><span style="color:red">*</span><br/>
              First Name: <input type="text" name="firstName"/><span style="color:red">*</span><br/>

              <br/>

              Birthdate: 
              
              <select name="dobDay">
                  <% for(i=1;i<32;i++){ %>
                  <option value="${i}">${i}</option>
                  <% } %>
              </select>
              <select name="dobMonth">
                <% for(i=1;i<13;i++){ %>
                  <option value="${i}">${i}</option>
                <% } %>
              </select>
              <select name="dobYear">
                <% for(i=2012;i>1900;i--){ %>
                  <option value="${i}">${i}</option>
                <% } %>
              </select>
              
              <br/> 

              Blk/House No.: <input type="text" name="blkHouseNo"/><br/>
              Street Name: <input type="text" name="streetName"/><br/>
              Unit No: #<input type="text" name="unitNo"/><br/>
              Country: <g:select name="country" from="${countries.countryName}"/><br/>
              Postal Code: <input type="text" name="postalCode"/><br/>

              Tel No.: <input type="text" name="telNo"/><br/>

              <input type="submit"/>

            </g:form>
            
        </div>
    </body>
</html>
